• Julien Guillotreau, Xavier Gamé, Marc Mouzin, Nicolas Doumerc, Richard Mallet, Federico Sallusto, Bernard Malavaud, and Pascal Rischmann.
• Service d'Urologie, Andrologie et Transplantation Rénale, CHU Rangueil, Toulouse, France.
• J. Urol. 2009 Feb 1; 181 (2): 554-9; discussion 559.

PurposeWe compared the morbidity and mortality of laparoscopic vs open surgery in radical cystectomy for bladder cancer.Materials And MethodsThis prospective, nonrandomized study was conducted between January 2003 and July 2007 in 68 patients (7 women and 61 men) who underwent radical cystectomy for bladder cancer. A total of 38 cystectomies were performed laparoscopically and 30 by open surgery. Mean patient age was 68.0 +/- 9.0 years. Median preoperative American Society of Anesthesiologists score was 2 (range 1 to 3) in both groups.ResultsIntraoperative blood loss and transfusion rate were significantly lower in the laparoscopic surgery group. Postoperatively the incidence of minor complications and mortality were also significantly lower. Postoperative opioid consumption was significantly less in the laparoscopic surgery group in amount and duration. Resumption of oral fluid and solid intake as well as return to normal bowel function were significantly more rapid in the laparoscopic surgery group, and mean hospital stay was significantly shorter. Mean patient followup was 30.5 +/- 17.2 months.ConclusionsLaparoscopic radical cystectomy for bladder cancer has a lower morbidity rate than cystectomy by open surgery. It allows more rapid resumption of oral fluid and solid intake as well as return to normal bowel function and shorter hospital stay.

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